For some critics, the health care reform "public option" is a visceral issue, a representation of a government intrusion into personal health decisions.
The nuts-and-bolts debate is unfolding in a different realm, where health care reform hinges on a colder calculus. How much will it "cost" to extend coverage to uninsured Americans — and does the "cost" create "savings" elsewhere in the system?
Our editorial board took a walk through this numbers game Wednesday during an interview with Steve Millard, president of the Idaho Hospital Association.
Early on in the debate, he said, the hospital industry decided it could absorb $155 billion cuts in Medicare reimbursement, in exchange for a reform package that would expand coverage. If more Americans were insured, the industry reasoned, the hospitals wouldn't have to write off as many unpaid emergency room visits and inpatient procedures — and would thus break even.
But the latest version of health care reform, emerging in the Senate, would add to Medicare and Medicaid rolls. And that would upset a fine balance, Millard said. Hospitals have to shift some Medicare and Medicaid costs to privately insured patients, in order to make up the difference between government reimbursement rates and actual costs. In essence, Millard says, his industry cannot sustain a drop in reimbursement rates and an increased shift to public insurance.
As a result, he said, any shift toward a public option (or public options) would have "disastrous" effects on health care access in Idaho.
This is, of course, a snapshot from just one perspective in the debate. But it shows just how difficult it is to strike a balance and craft a consensus — even when raw emotion is set aside.
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Not true
The hospitals love the current system BECAUSE of the cost-shifting, which makes them billions, especially the non-profits.
They want to preserve as much of the status quo as possible, keep jacking up rates, and keep passing them on.
Why are the drug salesmen always dressed the best then?
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What are you talking about?
Hospitals do not love the current system. If they did, organizations like Millard's and the national groups that represent hospitals would have voiced their outright opposition to this whole process from the beginning. Instead, they all advocate that the system needs to change. They haven't opposed reform in general but specific elements within the reform proposals.
Satisfying unlimited demands with finite resources...
We have to make some decisions regarding allocation of resources. Do we want to spend $600 billion+ a year on defense and wars/'nation building' in countries where we are not wanted, or provide healthcare for those among us who are 'the least of our brethern'.
I decide for war
The least of our brethern live in third world nations, and it would be foolish to provide them with healthcare and not liberate them from murderous regimes which cannot be done without military force.
The least of our brethern in this country have access to healthcare through Medicaid and/or public clinics or both. The uninsured above the poverty line are not the least of our brethern. The way to help them is to lower healthcare costs and stop confusing health care with health insurance. For far less than what Obamacare will cost, we could give every American, rich and poor, a medical credit card for essential medical services (no tummy tucks or botox) and quit wasting everyone's money on insurance. Then we would have to create jobs for the 2 million plus who work in the insurance industry, but that too is more doable than Obamacare. Try thinking like a Yankee instead of a government bureaucrat.
Yankees are good but overpaid and always controversial.
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Not to mention you don't need a war...
There are plenty of long, drawn out ways to make them suffer without shooting and bombing. Be a creative hawk.
That doesn't contradict what I wrote down below this but there are numerous paths to misery. Get moving already, you're slow.
Slackers. Always needing a jackboot in the rear or what?
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Make them suffer?
It is pretty clear who has suffered the most in the long drawn out process in Darfur isn't it? Whose side are you on? The rebels or China?
It's my pagan solstice celebration! They all die eventually? EH?
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One thing I can say in his favor...
Nixon really knew how to bomb.
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It is very clear those in
It is very clear those in power do not want what's best for the people, as the current bill contains no public option and fails to provide insurance companies with incentives to compete against each other.
Look at how one insurer has a monopoly in Idaho and our current health care costs continue to spiral out of control for people in Idaho, with absolutely no concerns by our elected officials.
If the over 300,000 uninsured Idahoans are forced by this current bill to buy health insurance without a public option, that one Insurer in Idaho has a boondoggle and no reason to provide affordable insurance rates ever again.
Health care reform was supposed to about the rights of a free human being in America having access to affordable services to maintain the life we a given.
That's the general rumor.
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By the way...where do you come up with ONE company?
Please ask Ernestine about this.
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Right
If the Idaho Hospital Association doesn't like it, we must be moving in the right direction. I remember years ago when there was much talk of government intervention to control rising health care costs. This was right before the big HMO push. The spin from St. Luke's was basically,"hey, we've got this, trust us." Health care costs leveled off for a few years and now they are once again rising quickly, and once again we are hearing the same, "let us fix this, you don't want that evil old government sticking its nose into our business." I say Idaho hospitals had their chance, just as the Republicans, and the insurance companies had their chance to get costs under control.They didn't and now I don't think they deserve a chair at the table. All three groups want the status quo.
And Kevin, who did you interview with a pro public option, or pro expanding Medicare point of view, in the spirit of trying to "strike a balance and craft a consensus."
Same old ignorance that floored y'all 7 years after 9/11.
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To bad its not obvious to
To bad its not obvious to those on all sides of the Health care issue these clowns have no idea what they are doing. Remember they wanted to finish this up by AUGUST and look at the changes they have made since then. None of their numbers add up and they remind me of a building contractor trying to get your name on a contract promising everything you ever wanted in a house for a real low price. Never mind none of that is written in the contract just sign up now and trust me. Its obvious Republicans have never been interested in reforming health care when they were in charge and its obvious Democrats will do or say anything to takeover the healthcare system completely without caringabout the costs. Most studies show medicare will be underfunded in 5 years and then what Dems your figures are smoke and mirrors. Its time both parties stop and start all over again. I wouldnt sign up for a two thousand page health insurance policy from Blue Cross would you?